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International Journal of Pharmacology
Year: 2021  |  Volume: 17  |  Issue: 6  |  Page No.: 408 - 413

Risk of Osteoporotic Fractures Caused by Methylprednisolone and Proton Pump Inhibitors in Chinese Rheumatoid Arthritis Patients

Yanjun Luan, Wenna Ji, Jianlin Zhang, Haibin Hou and Liang Xue    

Abstract: Background and Objective: Rheumatoid arthritis causes an elevated risk for Osteoporotic Fractures (OP). The present study aimed to investigate the risk for osteoporotic fractures on the combined use of methylprednisolone and Proton Pump Inhibitors (PPIs) among Chinese rheumatoid arthritis patients. Materials and Methods: A total of 4993 RA patients age between 55-75 were administered and exposure with methylprednisolone and proton pump inhibitors were investigated for the risk for osteoporotic fractures (OR). The exposure was stratified by the use of methylprednisolone and PPIs such as omeprazole, lansoprazole, rabeprazole, esomeprazole, pantoprazole and control (non-users). These subjects have been using the drugs for more than 24 months and above. Results: The combined users of methylprednisolone and PPIs had a mean age of 69.22 years compared to the 65.54 years of control. The combined users were linked with a 1.5 fold increased risk for OR compared with the control (OR = 1.56 (95% CI: 1.42-1.93)). It is observed that the OR fracture in the combined users had a 1.5 fold higher risk for hip fracture (OR = 1.52 (95% CI: 1.22-1.87), 3 fold higher risk for vertebral fracture (OR = 2.95 (95% CI: 1.92-4.27)), a 2.5 higher risk for pelvis fracture (OR = 2.51 (95% CI: 1.36-4.27)) and 4.1 higher risk for rib fracture (OR = 4.13 (% CI: 2.24-7.56)) compared to the control. Conclusion: There is an association in the risk for OR fracture between the combined use of methylprednisolone and PPIs due to the biological mechanism of action between methylprednisolone and PPIs on the bone of the RA patients.

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